肺癌手术中淋巴结清扫的现状与进展

淋巴结转移是肺癌主要而常见的转移途径，也是术后癌残留而导致复发和转移的主要因素，肺癌手术中纵隔、肺门淋巴结清扫至关重要。但目前淋巴结的清扫方式尚不统一，有系统淋巴结清扫术（CMLND）、根治性淋巴结清扫术、淋巴结采样、系统淋巴结采样以及前哨淋巴结技术导航切除，并且随着微创外科的发展，胸腔镜下淋巴结清扫也日趋成熟。而寻求一个更规范、更完善的淋巴结清扫方式甚有必要。现就目前肺癌手术中纵隔、肺门淋巴结清扫的临床意义、清扫方式、清扫范围以及胸腔镜下淋巴结清扫的现状以及展望进行综述。

Current Status and Progress of Lymphadenectomy in Lung Cancer Operation

Lymph node metastasis is the main and frequent metastatic way of lung cancer, it is also the reason of postoperative carcinoma residue which results in relapse and metastasis. It is vital to clean mediastinal lymph nodes and hilar lymph nodes in lung cancer operation. However, the patterns of lymphadenectomy are not yet uniform. There are complete mediastinal lymph node dissection（CMLND）, radical lymph node dissection（RLND）, lymph node sampling （LS）, systematic lymph node sampling（SS） and sentinel lymph node navigation（SLN）. And with the development of minimal invasive surgery, the thoracoscopic lymphadenectomy gets mature day by day. It is very necessary to find a more standardized and perfect patten of lymphadenectomy. This paper reviews the clinical significance, the pattens and the extent of mediastinal lymph node dissection and hilar lymph node dissection, and also reviews the current status and prospect of thoracoscopic lymphadenectomy.